CPHQ Performance and Process Improvement 2 — Questions and Answers
Question 1: A hospital notices its central line-associated bloodstream infection (CLABSI) rate has increased over 3 months. Which improvement methodology would BEST guide a structured root cause analysis?
- Lean Six Sigma DMAIC (Correct answer)
- Balanced Scorecard
- Gantt chart analysis
- Benchmarking survey
Correct answer: Lean Six Sigma DMAIC
DMAIC (Define, Measure, Analyze, Improve, Control) provides a structured framework for identifying root causes and implementing data-driven improvements.
Question 2: When using statistical process control (SPC), a point falling beyond the upper control limit on an X-bar chart indicates:
- Random common cause variation
- A special cause requiring investigation (Correct answer)
- Normal process performance
- An acceptable seasonal fluctuation
Correct answer: A special cause requiring investigation
Points beyond control limits signal special cause variation, which is non-random and requires investigation to identify and eliminate the assignable cause.
Question 3: A quality team wants to prioritize which of 12 identified process failures to address first. The MOST appropriate tool is:
- Run chart
- Failure Mode and Effects Analysis (FMEA) (Correct answer)
- Control chart
- Histogram
Correct answer: Failure Mode and Effects Analysis (FMEA)
FMEA scores each failure by severity, occurrence, and detectability to calculate a Risk Priority Number, enabling systematic prioritization of improvement efforts.
Question 4: In process improvement, 'waste' in the Lean framework includes all of the following EXCEPT:
- Overproduction of supplies
- Staff education and training (Correct answer)
- Unnecessary patient transport
- Waiting time between procedures
Correct answer: Staff education and training
Lean identifies eight types of waste (DOWNTIME), and staff education is considered value-added activity, not waste.
Question 5: A quality professional is evaluating whether a new patient discharge process is superior to the old one. Which statistical test is MOST appropriate for comparing two proportions?
- Student's t-test
- Chi-square test (Correct answer)
- ANOVA
- Pearson correlation
Correct answer: Chi-square test
The chi-square test is used to compare proportions or frequencies between categorical groups, such as discharge complication rates between two process groups.
Question 6: The 'P' in the PDSA cycle stands for:
- Perform
- Plan (Correct answer)
- Prove
- Prioritize
Correct answer: Plan
PDSA stands for Plan-Do-Study-Act, a cyclical improvement model used for testing changes on a small scale before wider implementation.
Question 7: Which of the following BEST describes a 'stretch goal' in healthcare performance improvement?
- A target set at the current national average
- An ambitious goal that requires innovative change to achieve (Correct answer)
- A minimum compliance threshold set by regulators
- A goal adjusted downward to ensure success
Correct answer: An ambitious goal that requires innovative change to achieve
Stretch goals are aspirational targets that exceed current performance and require fundamental process changes rather than incremental improvements.
CPHQ Performance and Process Improvement 2
A hospital notices its central line-associated bloodstream infection (CLABSI) rate has increased over 3 months.
Which improvement methodology would BEST guide a structured root cause analysis?